Individual
BERNADETTE CAROL MOXHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
214 STATE ST, SCHENECTADY, NY 12305-1806
(518) 372-8178
Mailing address
214 STATE ST, SCHENECTADY, NY 12305-1806
(518) 372-8178
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
247570
NY
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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